Investigating the spinal projection pathway of C-Tactile afferents
Research type
Research Study
Full title
Investigating the second order spinal projection pathway of C-Tactile afferents and their contribution to pain processing.
IRAS ID
232654
Contact name
Andrew Marshall
Contact email
Duration of Study in the UK
1 years, 5 months, 31 days
Research summary
There is a complex relationship between gentle touch and pain. Gentle caressing touch can reassure and reduce pain. Soft touch can also hurt. Patients with chronic pain often suffer intense discomfort with gentle touch, a symptom called allodynia, making wearing light clothing on the affected area intolerable. How gentle touch triggers these distressing symptoms is poorly understood. A nerve fibre recently recognised in humans, the C-tactile (CT) nerve, may hold the key to this puzzle.
CT nerves respond to soft, slow touch; the kind we typically associate with pleasant or comforting sensations. CT nerves project to brain regions important for processing emotional aspects of pain. How this information reaches the brain and whether there is interaction between pain and CT nerves in the spine is unknown.
To establish if signals from CT nerves interact with the pain signalling pathways in spinal cord before reaching the brain we will investigate the effects of cordotomy on pain and gentle touch. The cordotomy procedure treats cancer related pain by interrupting pain pathways in the spinal cord. Preliminary data from 20 cordotomy patients showed changes in gentle touch perception along with resolution of their pain. To verify and extend these important findings magnetic resonance imaging will be used to identify changes in brain activity to CT and higher intensity mechanical skin stimulation in patients following cordotomy. Activity will be compared to 15 age-matched healthy controls. Automatic changes in heart rate and sweating to both types of touch will also be measured. Assessments will take place at the Walton Centre NHS Foundation trust on 15 patients.
The findings will provide evidence for the anatomical basis of how touch can exacerbate pain and may also present a novel target for neuromodulatory treatments to enhance the therapeutic benefits of touch.REC name
North West - Preston Research Ethics Committee
REC reference
17/NW/0600
Date of REC Opinion
23 Nov 2017
REC opinion
Further Information Favourable Opinion